Healthcare Provider Details
I. General information
NPI: 1043651680
Provider Name (Legal Business Name): SARAH SWEENEY GUDE D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 07/11/2013
Last Update Date: 03/07/2024
Certification Date: 03/07/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3509 E 29TH ST
DES MOINES IA
50317-4253
US
IV. Provider business mailing address
1200 UNIVERSITY AVE STE 200
DES MOINES IA
50314-2355
US
V. Phone/Fax
- Phone: 515-248-1600
- Fax: 515-248-1610
- Phone: 515-248-1447
- Fax: 515-248-1440
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | DO-06613 |
| License Number State | IA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: